ABSTRACT
Traditional use of trans-annular patch [TAP] to release right ventricular outflow tract [RVOT] obstruction during tetralogy of Fallot [TOF] repair may lead to a harmful pulmonary regurgitation. Different approaches have been used to release RVOT obstruction and spare the pulmonary valve [PV] function. In this study, we aim to evaluate the post-operative course of patients who had TOF repair in the current era that emphasizes on protective strategy of releasing RVOT obstruction and preserving PV function. A retrospective study of all TOF cases repaired in our institute between March 2002 and December 2007 was conducted. Cases were classified into two groups; group I included patients that had a TAP, while group II included cases that had simple TOF repair without TAP. Group I was subdivided into two groups, group [A] which include patients who had TAP without a valve. Group [B] includes those who had TAP with a monocuspid valve [Contegra]. We compared postoperative care and outcome of all groups. Eighty-three patients fulfilled the study criteria. There were 64 cases [77%] in group I, and 19 cases [23%] in group II. All children tolerated surgical repair and did well. We observed no statistically significant difference in the post-operative ICU care, complications rates and morbidity between all groups. There was no surgical mortality in all groups. Children undergoing TOP repair had excellent short-term outcome with the current protective strategy aiming to spare valvular function, and conserving myocardial function. Applying a monocuspid patch technique did not show clear short-term benefits. Long term follow up is needed to evaluate future difference in different techniques